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It is fair to say that we have discussed delayed discharges over many years, and we acknowledge that things continue to be bad and are possibly worse than they were before. The witnesses on the previous panel and the current one have mentioned how important delayed discharge is in resolving some of the issues.

You have talked about recruitment of staff, staff pay, intermediate beds, the role that AHPs can have and, of course, the pay, terms and conditions and recruitment of social care staff. What support do you need from the Scottish Government to move forward? There is a lot of urgency, but it does not always feel as though we are moving forward at pace with any of the ideas from you and the staff about Government support.

That is very helpful. Is enough urgency being placed on that to get it through quickly enough? That is the key.

I want to be clear that I accept that the panel members want things to work and that they are working hard to get this in. However, I want to talk a wee bit about the reality that we observe and what we see in our in-boxes from patients who have waited on trolleys and have found that the staff work 100 per cent and above and beyond, but are still finding it difficult. Staff trade unions also tell us how much stress staff are under in relation to beds. The professional organisations tell us that, too.

I visited a local hospital at 9 o’clock on a Friday morning. There were three ambulances waiting to unload, every accident and emergency bay had had a patient in it for more than 24 hours, and the bed capacity was basically non-existent. I was told by staff and managers—everybody—that that situation was not unusual.

We need to be realistic about where we are, and we need to talk about whether there is enough support from the Government to help health boards. Will we have enough bed space this winter? The issue is not just bed space: I have been advised that the ratio of bed space to staffing is not at the level that we need even before we fill the beds—they are constantly getting staff in again and again.

I appreciate that you want things to work, but how realistic is it that things will be in a good space this winter?

I have a quick question for Leigh Johnston. Recently, it has been mentioned to me that one of our responses to Covid in hospitals was to increase bed capacity—which is understandable—and that that has continued. Some health boards are concerned that the staffing issues were never addressed. There are staffing issues to do with recruitment, and the full-time equivalent posts are simply not there. It was mentioned to me that staffing was running at around 70 per cent of the funding allocation. Is that something that you have picked up on across the board?

If I wanted to look at bed capacity before and after Covid, where would be the best place to look at that information and the staffing levels around that?

That is helpful. Thank you very much.

I am interested in that cross-departmental Government working, and I would be interested to know whether you have any examples of having done that well. You mentioned transport as being particularly important in rural areas.

I am also interested to know whether you can commit to asking the Deputy First Minister to give us some kind of plan, because it is key that the ministerial departments work closely together. Perhaps some kind of plan about how he sees the next year would be helpful, particularly in the remit of health inequalities.

I absolutely condemn the policies of the current Conservative UK Government. It was interesting that Dr Walsh said at a previous meeting that if we had a change in Government at UK level, that would make an enormous difference to what we could do, including as a devolved nation. However, it is important that we in this committee talk about what we can do in Scotland. I absolutely welcome your commitment to do everything that we can, and I assure you that I will do my very best to hold you to that.

I will talk a little bit about the evidence that Claire Sweeney, from Public Health Scotland, gave to the committee. If you do not mind, I will read out a few points that she made. She said:

“although we have talked about a lot of the challenges that we are facing in Scotland, the big message that I want to emphasise and get across is that we can do a lot about inequality. There are lots of levers and opportunities in Scotland to address it. It is by no means something that is intractable that we cannot address; we can address it.”

She went on to say:

“Given the millions of pounds that the public sector spends in Scotland every year, there is a huge opportunity to use that money to good effect, and we see many ... things”

that we could do in Scotland. She said:

“For example, we hold public bodies to account for financial and access targets, but we do not hold public leaders to account as strongly ... That is something really clear and tangible that could be done.”

She also said that she

“would like budgets and spend across Scotland to be more closely aligned to impact”,

on things such as

“reducing inequality and child poverty”.

and stated:

“It is about the early years, access to education and training, having good and fair work, having a good and affordable standard of living and having healthy communities in place so that people have access to green space, good transport”.

Finally, she noted that

“There is a lot of agreement on what can be done”,

and that we in Scotland need to

“mobilise the rest of the system”—[Official Report, Health, Social Care and Sport Committee, 31 May 2022; c 13-14.]

to do that.

It is. That work is very exciting and there is plenty to work towards. However, I think that Claire Sweeney was saying that, to get the full power behind it, the Government needs to be stronger in pushing public leaders. It would be good to have some kind of commitment from the minister on that. I think that we all agree that we need to push the people at the top to really see this as a priority so that all those things are brought to the fore.

Do the witnesses have any thoughts on how we can ensure that the system understands that people are entitled to that healthcare?